This article explores how staff in French public hospitals are indirectly involved in the governing of migration through healthcare. It unpacks the construction of differentiated values of life assigned to specific categories of vulnerable (authorised and unauthorised) migrants according to their perceived un/deservingness in context of budgetary restrictions. This context emphasises tensions between medical and administrative staff in the decision-making process regarding access to healthcare. The analysis rests upon empirical data (participant observations and semi-directed interviews) gathered in ‘healthcare access units’ located in public hospitals. Perceptions of un/deservingness lead to both healthcare rationing and healthcare denial and are built upon entangled criteria related to both migration status and budgetary concerns. These mechanisms reveal the administrative and budgetary dimensions that underlie the perceptions of health-related un/deservingness, which is linked to the costs of healthcare: the higher the costs, the less likely patients are to be designated to be deserving of healthcare.

Objectives: The aim of this study was to evaluate the direct costs of type 2 diabetes mellitus patients treated in a Brazilian public hospital.

Methods: This was an exploratory retrospective cost-of-illness study with quantitative approach, using medical records of patients treated in a public hospital (2012–14), with at least one consultation over a period of 12 months. Data on patient's profile, exams, number of consultations, medications, hospitalizations, and comorbidities were collected. The cost per patient per year (pppy) was calculated as well as the costs related to glycated hemoglobin (HbA1c) values, using thresholds of 7 and 8 percent.

Results: Data of 726 patients were collected with mean age of 62 ± 11 years (68.3 percent female). A total of 67.1 percent presented HbA1c > 7 percent and 44.9 percent > 8 percent. The median cost of diabetes was United States dollar (USD) 197 pppy. The median costs of medication were USD 152.49 pppy, while costs of exams and consultations were USD 40.57 pppy and 8.70 pppy, respectively. Thirty-eight patients (4 percent) were hospitalized and presented a median cost of 3,656 per patient per hospitalization with a cost equivalent to 53.1 percent of total expenses. Total costs of patients with HbA1c ≤ 7 percent were lower for this group and also costs of medications and consultations, whereas for patients with HbA1c ≤ 8 percent, only total costs and costs of medications were lower when compared with HbA1c > 8 percent patients.

Conclusions: Medications and hospitalizations were the major contributor of diabetes expenses. Preventing T2DM, or reducing its complications through adequate control, may help avoid the substantial costs related to this disease.